J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1425KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 94(10): 1159-1163, 1993

Case report

CASE OF DIFFUSE ESOPHAGEAL SPASM TREATED BY LONG MYOTOMY

1) Second Department of Surgery, Osaka City University Medical School, Osaka, Japan
2) Department of Clinical Pathology, Osaka City University Medical School, Osaka, Japan

Toyokazu Okuda1), Masayuki Higashino1), Harushi Osugi1), Noriaki Maekawa1), Shinya Tanimura1), Hiroaki Kinoshita1), Kenichi Wakasa2)

Diffuse esophageal spasm is a rare condition, which has generally been treated conservatively in Japan. A case of this disorder treated successfully by long myotomy is reported with a knowledge of prolonged pressure monitoring of the esophagus.
A 56-year-old woman was admitted to our hospital with dysphagia. Barium swallow and esophagoscopy showed contraction of the esophagus, and manometry showed normal peristalsis, so the diagnosis of achalasia was ruled out. Prolonged pressure monitoring of the esophagus showed spastic contractions with the pressure over 130 mmHg that continued for 25 sec during meals, which led us to the diagnosis of diffuse esophageal spasm. Extramucosal long myotomy of the esophagus and a modified Belsey Mark IV operation were performed.
The postoperative course was satisfactory and esophageal functional tests showed no spasms. The patient regained weight without dysphagia.

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